Is sentinel node biopsy necessary in the radiologically negative axilla in breast cancer?

Jozsa, F; Ahmed, M; Baker, RD; Douek, M

Abstract

Purpose: The steady move towards axillary conservatism in breast cancer is based on studies demonstrating that axillary node clearance affords no survival benefit in a subset of patients with a positive pre-operative axillary ultrasound (AUS). However, less attention has been paid to AUS-negative patients who receive sentinel node biopsy as standard.

Methods: Previously assembled systematic review data was reassessed to evaluate nodal burden amongst patients with breast cancer and a clinically and radiologically negative axilla.


Results: Pooled data from four cohort studies reporting pre-operative axillary ultrasound in 5139 patients with breast cancer show it has a negative predictive rate of 0.951 (95% confidence interval 0.941–0.960).


Conclusions: Reconsidering the use of ultrasound in patients with early breast cancer and non-palpable axillae reveals that sentinel node biopsy itself may represent surgical over-treatment in patients with a negative axillary ultrasound. The implications of this on the future of surgical management of the axilla are discussed.

Citation

Jozsa, F., Ahmed, M., Baker, R., & Douek, M. (2019). Is sentinel node biopsy necessary in the radiologically negative axilla in breast cancer?. Breast Cancer Research and Treatment, 177, 1-4. https://doi.org/10.1007/s10549-019-05299-5

• Journal Article Type: Article
• Acceptance Date: May 25, 2019
• Online Publication Date: May 31, 2019
• Publication Date: Aug 30, 2019
• Deposit Date: Jun 3, 2019
• Journal: Breast Cancer Research and Treatment
• Print ISSN: 0167-6806
• Electronic ISSN: 1573-7217
• Publisher: Springer Verlag
• Volume: 177
• Pages: 1-4
• DOI: https://doi.org/10.1007/s10549-019-05299-5
• Publisher URL: https://doi.org/10.1007/s10549-019-05299-5
• Related Public URLs: https://link.springer.com/journal/10549